What is your Kryptonite?

[MassED, BSN, RN]

i know working in the er, after some time, you feel like you're a jack of all trades, that you can handle *just about* anything, within reason. many times you learn as you go, but for the most part, you can handle the fundamentals on the spot. you've handled that multi-trauma, gi bleed, stemi, mvc, appendicitis, ruptured ectopic, amputation, septic patient... etc etc. i had read somewhere in an ena journal that it is an impossibility to be an expert at all things that you come across as an ed nurse. i completely believe this. we each bring a specific skill set that can be pulled together when needed.

now is it just me, or is there *one* thing that is your kryptonite? that one thing that you would think you should know more about, but doesn't happen that often, and when it does, you have a bit more fear than any other nursing skill/experience? how do you handle that?

for me, dealing with iv's (now scalp veins) on kiddos younger than 6 months or so. i just don't like it. let me add, i haven't had to do it... yet. do not like it. don't mind the straight caths and all that, but it occurred to me today that i don't even want to immerse myself in all things peds because even though i'll do what i need to do for that peds patient, i really really do not like it. we all have our strengths and weaknesses - what can i say? or should i say we all have our aversions.

what is it that you find to be your aversion in the ed? and i mean a true aversion, not just an illness that is gross or time consuming, but something you just don't want at all. i know there are many nurses out there who don't like this either, so this isn't new, but wondering what other nurses, having worked in an ed for some time feel about this too. you will do what you have to, though, to get through and get it done.

as a sidenote, i just saw my first scalp vein insertion and this dude made it look remarkably easy after three unsuccessful peripheral sticks. i know it's a matter of just doing it and it will likely take that fear away.... but i still don't like little babies to cry and cry. it is one of those things, even as a parent, that when a baby cries, you want to soothe. it frazzles me, what can i say? perhaps desensitization, some might say, but having kids, that doesn't work. i like a warm, content, smiling baby. :)

i once heard a peds nurse say, in the midst of a sea of crying kids.... "ahhhh, this is my comfort zone." that is what separated the likes of her from the likes of me, i must say. that was an "aha" moment for me. you love what you love! you can't force to love who you just don't love!

[Dalzac, LPN, LVN, RN]

Open head wounds and skull fractures and the neuro that goes with them. I just couldn't think and would freeze up like nobody's business. I would beg to go to workshops about them and would go and still freeze on them. I just could never figure it out. But I did okay with strokes and that neuro. Just not traumatic neuro

[MassED, BSN, RN]

yeah traumatic neuro is a tricky thing. I had a young-ish man who came in w/ a skull fracture, shift... I noted some cardiac arrythmias... some pauses and brady'ing down... scary stuff. The doc told the family "oh these things happen with head injuries and it scares the staff...." Uh hello! Worsening bleed, perhaps??? Glad we got the kid out of our critical care up to the ICU where he then went for surgery after his repeat CT showed worsening bleed.

[NewTexasRN]

I work on a ortho unit and when they float other nurses from other units some of them freak out. I love it because it's my comfort zone. I can handle medical patients, but I'm not good at reading rhythm strips.

[edogs334]

Yeah, something neurosurgical- like a patient with an IVC drain or a Camino Bolt- well, especially an IVC drain. No matter how often other nurses and my manager have explained how an IVC drain works, I still can't get it straight in my head (I've never had a patient with one, though). I'm afraid I'd turn the stopcocks the wrong way at the wrong time, thus fatally increasing the patient's ICP without realizing it

Oh yeah, and screaming kids are NOT my comfort zone- my anxiety level went up whenever I was floated to the peds ED as a tech. I think it's kinda twisted that anyone would consider screaming kids their comfort zone (but maybe peds nurses couldn't imagine working with adults- especially some of the patients I work with).

[GM2RN]

I'm not sure what scares me like that. I work in a mid-sized hospital and we don't get really bad traumas unless they need to be stabilized before transferring to another hospital. If something like that did come in, there would be other nurses and docs right in the room to get the job done and get them shipped out, so I wouldn't be alone in that situation.

The only thing I can think of right now that might be my aversion is bad burns. I can't imagine trying to get a line in someone with charred or missing flesh. But again, I wouldn't be alone in that situation.

Maybe I'll think of something after a few more posts.

[nursejoed]

My weakness is dealing with quadriplegia. Honestly, I'd rather be dead than a quad, so I feel lots of emotions dealing with others in that situation....

[mmutk, BSN, RN, EMT-I]

I feel you on the stopcocks for CVP, Arterial Lines, and ICPs. It took me a good year in the SICU before I finally got comfortable with them.

[tainted1972, ASN, RN]

Anything involving children, I just cannot handle it. Babies and kids are supposed to be healthy and shouldnt be dying, it seems so unreal and unnatural to me. My worst fear is to be involved in a situation where a child dies ( my fault or not).

[ERnewbieRN, BSN, RN]

I hate dealing with altered patients trying to climb out of bed, pulling out lines, being aggressive... and overdoses which involve NG tubes and administration of charcoal. UGHHHHHHHH!!!!!

[ImThatGuy, BSN, RN]

Hot blondes are mine.

[Lunah, MSN, RN]

Hee ... we had a similar thread I started not long ago, lots of good answers in that one:

What's your Kryptonite? - Nursing for Nurses